Youth to Youth in Health, Inc.

Published 2017

Republic of the Marshall Islands Teen Pregnancy Prevention Project


  • In 2015, Youth to Youth in Health, Inc. was awarded a grant from the HHS Office of Adolescent Health (OAH) Teen Pregnancy Prevention (TPP) program for the Republic of Marshall Islands Teen Pregnancy Prevention Project (RMI TPP Project).
  • The RMI TPP Project implements three evidence-based teen pregnancy prevention programs that were translated into Marshallese: Draw the Line / Respect the Line (6th, 7th, and 8th grade), Reducing the Risk (9th and 10th grade), and the Safer Sex Intervention (within clinical settings).
  • The RMI TPP Project collaborates with a variety of partners and coordinates a Community Advisory Group and Youth Leadership Group to capture the voice of youth and the community in their project.


In July 2015, the HHS Office of Adolescent Health (OAH) awarded 84 Teen Pregnancy Prevention (TPP) program grants. Youth to Youth in Health, Inc. is a non-profit organization with a strong history in the Republic of the Marshall Islands (RMI). Teen pregnancy is high in the Pacific region, with the highest rate in RMI. The OAH grant is the first dedicated funding that RMI has received for teen pregnancy prevention. Through this initiative, the RMI TPP Project implements programming in the Delap-Uliga-Djarrit, Laura, and Kwajalein communities.

“Please come and teach us more about your program, because we don’t want to get unintended pregnancies or get infected while we are in school. We really need more information regarding teens getting pregnant, how to protect ourselves, and promote the knowledge to our friends and families.”
- 10th grader at Marshall Islands High School

“[This program is] vitally important for this nation’s communities and the society as a whole. I do appreciate this program in schools. It is going well with us at Marshall Islands High School.”
- Marshall Islands High School teacher

About Youth to Youth Health, Inc.

RMI is a nation of 56,000 people faced with high rates of teen pregnancy, substance use, and diabetes. Power outages, a recent drought, and an outbreak of tuberculosis have added pressures for Youth to Youth in Health, Inc. (YTYIH), a non-profit organization with more than three decades of experience empowering young people throughout the Marshallese community. The commitment and persistence of its staff has enabled successful implementation of the RMI TPP Project, a program designed to build knowledge, skills, and self-esteem for young people in a safe and supportive learning environment. The project goals are to reduce the rates of unintended pregnancies and sexually transmitted infections by 40 percent in the communities served.

The RMI TPP Project collaborates with a variety of partners to ensure strong community support for the initiative and an environment that supports positive youth development. Through a partnership with the Public School System, they implement evidence-based teen pregnancy prevention curricula, engage youth through school health clubs and workshops, and conduct outreach to engage parents. The RMI TPP Project also works closely with the Ministry of Health, which joins them for outreach at community events. In collaboration with the Ministry of Internal Affairs (MOIA) as well as local clubs, religious groups, other government agencies, and traditional leaders, the RMI TPP Project runs a Youth Leadership Group and a Community Advisory Group in each target community. The members of these groups assist YTYIH staff with meetings, outreach, and decisions about which topics to discuss within the community. MOIA provides a weekly radio spot where the Youth Leadership Group disseminates announcements about upcoming events as well as reads role-plays from the program curricula to model healthy relationships and how to employ delay tactics and refusal skills. This allows youth who live in outer islands or who attend a school without the curricula to also learn about these skills and gain access to information.

Why it Matters

The OAH TPP program’s funding for the RMI TPP Project is an investment in reducing rates of teen pregnancy. The work the RMI TPP Project does:

  • Addresses an area with persistently high teen birth rates. The Republic of the Marshall Islands (RMI), a sovereign nation under a Compact of Free Association with the United States and located about midway between Hawaii and Australia in the Pacific Ocean, has the highest rate of teen pregnancy among Pacific Island nations. Though their teen pregnancy rate has declined by approximately 50 percent since 1990, compared to the 12 other island nations, RMI had the highest teen pregnancy rate in 2011, as it also did nearly three decades ago.
  • Works to improve outcomes for the youth in the areas served. By working alongside other prevention efforts, the RMI TPP Project helps the community understand how other risk factors, such as substance abuse and suicide, can be related to unintended pregnancy. The RMI TPP Project positively impacts social outcomes by helping improve educational attainment, improve child well-being, and reduce poverty.
  • Establishes strong partnerships to break through cultural barriers. In collaborating with the government, traditional and religious leaders, and distinguished organizations, the RMI TPP Project ensures teen pregnancy prevention efforts, including the evidence-based programs, are appropriate for and accepted by the community.

RMI Teen Pregnancy Prevention Project by the Numbers

  • U.S. Teen Birth Rate (2015*): 22 per 1,000 females ages 15-19
  • U.S. Teen Birth Rate (2011): 31 per 1,000 females ages 15-19
  • Marshall Islands Teen Birth Rate (2011*): 85 per 1,000 females ages 15-19
  • Samoa (2011*): 50 per 1,000 females ages 15-19
  • Federated States of Micronesia (2011*) 20 per 1,000 females ages 15-19

* Reflects the most recent year for which data are available.


Todd Mulroy, Program Director

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About the Office of Adolescent Health TPP Program

The OAH Teen Pregnancy Prevention program is a national, evidence-based program that funds diverse organizations working to prevent teen pregnancy across the United States. OAH invests in the implementation of programs identified as evidence-based by the HHS Teen Pregnancy Prevention Evidence Review and provides funding to develop and evaluate new and innovative approaches to prevent teen pregnancy.